摘要目的 探讨血清白细胞介素17(IL-17)和肿瘤坏死因子α(TNF-α)及滑膜病变检测在类风湿关节炎(RA)患者中的临床意义.方法 应用酶联免疫吸附测定法(ELISA)对50例活动期RA患者(活动期RA组)、50例稳定期RA患者(稳定期RA组)和50例体检健康者(健康对照组)血清IL-17和TNF-α水平进行检测,同时取其关节滑膜进行病理检查.结果 活动期RA组血清IL-17和TNF-α水平[(42.60±11.30)、(113.20±13.11) mg/L]明显高于稳定期RA组[(19.60±5.75)、( 14.50±5.33) mg/L]和健康对照组[(7.40±3.32)、( 10.90±2.24) mg/L](P＜ 0.01);稳定期RA组血清IL-17水平高于健康对照组(P＜0.05),而TNF-α水平与健康对照组比较差异无统计学意义(P＞0.05).RA患者的滑膜与健康对照组相比呈明显的病态.结论 RA患者血清IL-17和TNF-α水平及滑膜病变的变化特点与病情有关,联合动态监测有助于临床观察和治疗.

abstractsObjective To investigate the levels of serum interleukin -17(1L-17) and tumor necrosis factor -alpha( TNF- α ) and synovium pathological changes in patients with rheumatoid arthritis ( RA ) and its clinical significance.Methods The levels of serum IL-17 and TNF- α in 50 patients with active phase of RA ( active phase of RA group),50 patients with stable phase of RA ( stable phase of RA group ) and 50 normal controls (NC group) were measured by enzyme-linked immunospecific assay(ELISA),and the synovium was detected by pathological examination.Results The levels of serum IL- 17 and TNF- α in active phase of RA group [(42.60 ± 11.30),( 113.20 ± 13.11 ) mg/L]were significantly higher than those in stable phase of RA group [( 19.60 ± 5.75),( 14.50 ± 5.33) mg/L]and NC group [(7.40 ± 3.32),( 10.90 ± 2.24 ) mg/L](P ＜0.01 ),the level of serum IL-17 in stable phase of RA group was significantly higher than that in NC group ( P ＜ 0.05),but the level of TNF- α had no significant difference between stable phase of RA group and NC group ( P ＞ 0.05).The synovium was significantly different between RA patients and NC group.Conclusion IL-17 and TNF-α are more sensitive index for detecting the activity of RA and may play important roles inmonitoring the therapeutic effects and prognosis of RA.